colorectal leiomyosarcoma
Introduction
Introduction to large intestinal leiomyosarcoma The incidence of gastrointestinal leiomyosarcoma is in the stomach, small intestine, and large intestine, and the rectum is more common in the large intestine. Large intestine leiomyosarcoma is rare. Colorectal leiomyosarcoma often has no specific clinical manifestations. In the early stage, only general digestive symptoms such as abdominal discomfort and abdominal pain occur. When the tumor invades the mucosa, bloody stools or mucus bloody stools may occur. When the tumor grows too much, defecation may occur. Intestinal obstruction. basic knowledge The proportion of the disease: the disease is rare, the incidence rate is about 0.0001% - 0.0002% Susceptible people: no specific people Mode of infection: non-infectious Complications: intestinal obstruction
Cause
Causes of large intestine leiomyosarcoma
(1) Causes of the disease
Large intestine leiomyosarcoma originates from the muscular layer of the intestinal wall, and a few originate from the mucosal muscle layer and vascular smooth muscle.
(two) pathogenesis
Tumors vary in size, up to tens of centimeters in size, less than 1 cm in small cases, and type 4 in large categories:
1. Endoluminal type: Also known as submucosal type, the tumor tissue protrudes into the cavity and grows mainly under the mucosa.
2. Extraluminal type: also known as subserosal type, the tumor tissue mainly grows outside the intestinal wall.
3. Mixed type: The tumor grows in the intestinal lumen at the same time between the intestinal wall, and is mostly dumbbell-shaped.
4. Intra-wall type: also known as constriction type, tumor tissue grows along the intestinal wall, often involving the entire circumference of the intestinal wall, causing narrowing of the intestinal lumen.
Histopathological types can be divided into well-differentiated sarcoma and poorly differentiated sarcoma according to the degree of differentiation. At present, most scholars believe that the degree of malignant leiomyosarcoma increases with the increase of mitotic phase. In addition to local infiltration of adjacent organs and tissues, hemoptysis is disseminated. Its main metastatic pathway, lymph node metastasis is rare.
Prevention
Colorectal leiomyosarcoma prevention
1. Have a good attitude to cope with stress, work and rest, not excessive fatigue. Visible pressure is an important cause of cancer. Chinese medicine believes that stress causes cancer to prevent physical weakness, which leads to decreased immune function, endocrine disorders, metabolic disorders in the body, leading to the deposition of acidic substances in the body. Stress can also lead to qi stagnation and blood stasis caused by mental stress. Poisonous fire invagination and so on.
2. Strengthen physical exercise, enhance physical fitness, and exercise more in the sun. Excessive sweating can excrete acidic substances in the body with sweat, avoiding the formation of acidic constitution.
3. People who have regular life and irregular living habits, such as singing karaoke, playing mahjong, and not returning to the night, will have aggravated physical acidification and are prone to cancer. Good habits should be developed to maintain a weak alkaline constitution and keep various cancer diseases away from you.
Complication
Colorectal leiomyosarcoma complications Complications, intestinal obstruction
When the tumor invades the mucosa, bloody stools or mucus bloody stools may occur. When the tumor grows too much, defecation or intestinal obstruction may occur.
Symptom
Symptoms of large intestine leiomyosarcoma Common symptoms Diarrhea Abdominal discomfort Mucus and abdominal pain
Colorectal leiomyosarcoma often has no specific clinical manifestations. In the early stage, only general digestive symptoms such as abdominal discomfort and abdominal pain may occur. When the tumor invades the mucosa, bloody stools or mucus bloody stools may occur. When the tumor grows too much, defecation may occur. Intestinal obstruction.
Examine
Examination of large intestine leiomyosarcoma
Pathological biopsy: Because the tumor is derived from the smooth muscle layer, it must reach a certain depth when taking the material, and should be taken from multiple places. Sometimes the identification of benign and malignant is not easy.
1. Rectal diagnosis: Because the large intestine leiomyosarcoma occurs in the rectum, this test has great significance for providing diagnostic clues. It can often touch round or elliptical masses, with toughness such as rubber, poor mobility and smooth mucous membrane. Mucosal invasion and ulceration are more difficult to distinguish from cancer.
2. Air sputum double contrast examination: mainly manifested as filling defect, stenosis of the lumen, and no mucosal changes. When the tumor invades the mucosa, it may appear shadow, which is difficult to distinguish from ulcerative cancer.
3. Fiber colonoscopy: visible submucosal space changes, the intestinal lumen showed external pressure changes.
4. Intra-rectal ultrasound and abdominal/pelvic CT examination: It is helpful for the diagnosis of this disease, and it has certain significance for determining the operation mode.
Diagnosis
Diagnosis and differential diagnosis of large intestinal leiomyosarcoma
Diagnostic criteria
The diagnosis of this disease is often difficult, laboratory and other auxiliary examinations are helpful for diagnosis, but lack specificity.
1. Clinical manifestations.
2. Laboratory and other auxiliary inspections.
Differential diagnosis
1. Crohn's disease: Crohn's disease with abdominal pain, diarrhea, abdominal mass, fever, weight loss for its clinical features, and easy to have intestinal obstruction, intestinal perforation, fistula formation, etc., similar to radiation enteritis, tincture enema display Intestinal stenosis, lesions in the intestines were hopping, paving stone signs and fistula or sinus formation, longitudinal fissure ulcers were seen under endoscopy, intestinal mucosal paving stone changes, colonic bags disappeared and flattened in water tubules, lesions showed a jump distribution The above changes are not difficult to identify with radiation enteritis.
2. Colon polyps: There may also be blood in the stool, changes in bowel habits, abdominal pain and other symptoms, easily confused with colon cancer, but colonoscopy and biopsy can be identified.
3. appendix abscess: history of acute or chronic appendicitis or right lower quadrant pain, may have tenderness in the lower right abdomen and abdominal muscle tension, peripheral blood picture is elevated, abdominal B-ultrasound or CT examination can be found in the lower abdomen fluid mass, colonoscopy or sputum X-ray examination of the enema can rule out cecal tumors.
